DOCSLIB.ORG

Tuberculous Gumma Or Metastatic Tuberculous Abscess As Initial Diagnosis of Tuberculosis in an Immunocompetent Patient: an Unusual Presentation

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Tuberculous Gumma Or Metastatic Tuberculous Abscess As Initial Diagnosis of Tuberculosis in an Immunocompetent Patient: an Unusual Presentation Rev Esp Sanid Penit 2014; 16: 59-62 39 A Marco, R Solé, E Raguer, M Aranda. Tuberculous gumma or metastatic tuberculous abscess as initial diagnosis of tuberculosis in an immunocompetent patient: an unusual presentation Revisions of Clinical Cases: Tuberculous gumma or metastatic tuberculous abscess as initial diagnosis of tuberculosis in an immunocompetent patient: an unusual presentation A Marco, R Solé1, E Raguer1, M Aranda1 Servicios Sanitarios del Centro Penitenciario de Hombres de Barcelona (CPHB) y Servicio de Medicina Interna del Hospital Consorci Sanitari de Terrasa (HCST)1. ABStract Background and Objectives: Tuberculous cold abscesses or gumma are an unusual form of tuberculosis. We report a case of gumma as initial diagnosis of disseminated tuberculosis. Method: This case was studied in 2012 in Barcelona (Spain). Source data was compiled from the electronic clinical records, hospital reports and additional diagnostic testing. Results: Immunocompetent inmate, born in Cape Verde, living in Spain since the age of four. Positive tuberculin skin test. Initial examination without interest, but a palpable mass in lower back. Fine needle aspiration of the abscess was positive (PCR and Lowenstein) for M. tuberculosis. Computed tomography showed lung cavitary nodes in apical part and lung upper right side. After respiratory isolation, antituberculous therapy and an excellent evolution, the patient was discharged from hospital with disseminated tuberculosis diagnosis. Discussion: It is advisable to monitor the injuries since, although rare, it may be secondary to Mycobacterium tuberculosis infection, mainly in inmuno-compromised populations and in immigrants coming from hyper-endemic tuberculosis areas. Keywords: Prisons; Tuberculosis, cutaneous; Spain; Diagnosis, Differential; Endemic Diseases; Abscess; HIV. Text received: 24-10-2013 Text accepted: 17-01-2014 1. INTRODUCTION ous disease account for less than 0.5% of all cases in developed countries and its prevalence is even lower In 2010 there were almost 9 million new cases of if we exclude tuberculosis due to BCG and tubercu- tuberculosis (TB) worldwide which were responsible lids. The main objective of this report is to present the for 350,000 deaths among HIV patients and for 1.1 case of a young man without congenital or acquired million deaths among non HIV patients. In spite of immunodeficiency who was diagnosed with miliary these figures the absolute number of TB cases has fol- tuberculosis from a soft tissue abscess located in the lowed a decreasing trend ever since 2006 instead of lumbar region. the rise which had been predicted1. The main clini- cal presentation is pulmonary tuberculosis although bacillus disseminated during the initial infection may 2. METHODS be hosted in any tissue. Extrapulmonary forms repre- sent 10 to 20% of TB cases among immunocompetent Clinical case studied and diagnosed between patients but this presentation increases in immuno- March and May 2012 by the medical services of the compromised hosts. The main extrapulmonary sites Male Prison of Barcelona (Centro Penitenciario de of infection are lymph nodes, the osteoarticular sys- Hombres de Barcelona CPHB) and the department tem, the genitourinary system, the meninges and the of internal medicine of the Hospital Consorci Sanitari brain. Other clinical presentations such as the cutane- in Terrassa (HCST). For the description of the casa, — 59 — 40 Rev Esp Sanid Penit 2014; 16: 59-62 A Marco, R Solé, E Raguer, M Aranda. Tuberculous gumma or metastatic tuberculous abscess as initial diagnosis of tuberculosis in an immunocompetent patient: an unusual presentation data was collected from the patient’s clinical record, sediment was normal. Thoracic x rays revealed a right from the hospital’s record (both emergency and pro- loculated pleural effusion, superior-anterior pleural grammed stay records) and from complementary tests thickening, medial mediastinal widening with paratra- conducted. cheal subcarinal and right parahilar occupation. An ill defined approximately 4 cm wide mass was also iden- tified in the right upper lobe (RUL) which contacted 3. RESULTS with the pleura, together with right costophrenic angle blunting. CT of the chest and abdomen showed 35 year old male, natural from Cape Verde who a right apical cavitated nodule (1.8 x 1.6 cm) in the has lived in Spain ever since he was 4 years old. He pulmonary parenchyma, with adjacent micronodules, is currently imprisoned in Barcelona. He has been a 6mm wide nodule in the RUL and subsegmental smoking 10 cigarettes per day until 6 months ago and atelectasis in the middle lobe (ML), nodular thick- he occasionally smokes marihuana. He doesn’t report ening of the right apical pleura and affected medias- any other toxic habits. He has a history of multi- tinal pleura with an important left pleural effusion. ple fractures, some of which required surgery, after Furthermore, hypodense collections in intercostals falling from a fourth floor 16 months ago. In 2008: muscles, in the right adductor muscle and in right tuberculin intradermal reaction (IDR) of 25 mm. (5.8x3x2.5 cm) and left (4.4x3.2x1.6 and 1.9x1.5 cm) approximately one month and a half ago he initiated a paravertebral muscles were identified. Thoracentesis clinical picture of lumbar pain, dysthermic sensation, of the left hemithorax was conducted and the follow- shivering, dysuria, muscle cramps and paresthesia. ing was revealed: 40 cc of yellowish liquid (increased He received treatment based on anti-inflammatory ADA 2.2 ukat/L and negative cytology for malignant drugs and norfloxacin, with no improvement. He was cells). The aspiration puncture of the left lumbar lump then transferred to the emergency department of the revealed 10 cc of purulent liquid positive for M.tu- reference hospital. Blood tests showed the following berculosis by means of PCR testing and culture in results: CRP 17.7 mg/dl, normal leukocyte levels with the Löwenstein medium. The determination of lym- relative neutrophilia and leukopenia, thrombocytosis phocytic subpopulations (CD3, CD4, CD4 and coef- (448000/mcl), PT 65% and fibrinogen 9g/l. Abdom- ficients) revealed no alterations. Antibiogram tests inal and lumbar radiologic studies showed no patho- showed that the strain was sensitive to all the anti-TB logic results. Ultrasound examination of the kidneys, drugs. Sputum smear microscopy could not be con- bladder and prostate was then conducted to rule out ducted as the patient was not expectorating. A 4-drug dilatation of the excretory system. Lithiasis was also regimen together with respiratory isolation was ini- ruled out. A small unspecific 1.2 cm wide nodule was tiated. After the fever had disappeared together with identified in the middle prostate lobe which should be the lumbar pain and his general situation improved monitored in the future. A urine culture was ordered after the reduction of the left pleural effusion the before the possibility of urinary tract infection and patient was discharged and diagnosed with military the patient returned to the prison under treatment TB (pleural, pulmonary and muscle abscesses). The with cefixime 400 mg/24 h for 3 weeks, pending the surgery department managed the lumbar lump by results of the culture and the eventual adjustment of means of repeated aspiration punctures (See Figure 2). treatment according to the results of the antibiogram. A few days later, the results were informed to be negative by phone and an ultrasound conducted 4. DISCUSSION in prison showed minimum right effusion. Since the clinical manifestations persisted and the patient had Tuberculous abscesses are a relatively common eventually presented with constitutional symptoms complication of TB spondylitis 2, 3 and in such cases (weight loss, fatigue, anorexia and fever of 37.5 to 30ª, the psoas or paravertebral muscles may become mostly in the evening) he was admitted to the HCST affected, even years after the diagnosis has been made to continue the study. 4. Although it is a rare condition, tuberculous abscesses Upon hospital admission the patient had fever have also been described months after BCG vacci- (39ª). The physical examination was unspecific except nation 5. Nevertheless, cold abscesses or gumma are for the existence of a 5cm wide soft tissue lump on the actually a consequence of the metastatic spread, via the lumbar region (see Figure 1). Tumor markers, sero- blood, of latent mycobacteria which form abscesses logic testing for syphilis, hepatitis B and C and HIV most frequently in the limbs or the trunk usually spar- as well as blood culture tests were all negative. Urine ing deeper tissues. This is probably the physiopatho- — 60 — Rev Esp Sanid Penit 2014; 16: 59-62 41 A Marco, R Solé, E Raguer, M Aranda. Tuberculous gumma or metastatic tuberculous abscess as initial diagnosis of tuberculosis in an immunocompetent patient: an unusual presentation logical mechanism that this patient suffered. There are few cases of tuberculous gumma in the literature and although they are more usually found in countries with high endemicity of TB 6, 7 they have also been described in other countries such as Japan 8 or the United States 9. Nevertheless, throughout recent years this presentation has experienced an increase mostly associated to immunocompromised patients10, mostly those infected by HIV 11. It has also been suggested that such presentations may be more frequent among the imprisoned population12, especially in prisons-like ours- where over 61% of those hosted are immigrants, coming
Load more

Recommended publications
  • Cutaneous Tuberculosis: a Twenty-Year Prospective Study
    INT J TUBERC LUNG DIS 3(6):494–500 © 1999 IUATLD Cutaneous tuberculosis: a twenty-year prospective study B. Kumar, S. Muralidhar Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India SUMMARY SETTING: A tertiary care hospital in northern India. the spectrum of cutaneous tuberculosis (22.1%), but OBJECTIVE: To study the patterns of clinical presenta- was seen more often in the presence of gumma and tion of cutaneous tuberculosis, to correlate them with scrofuloderma. There were more unvaccinated individ- Mantoux reactivity and BCG vaccination status, and to uals in the group with disseminated disease (80.3%) suggest a clinical classification based on these factors. than in those with localised disease (65.5%). DESIGN: Analysis of the records of patients with cuta- CONCLUSIONS: Lupus vulgaris was the most common neous tuberculosis who attended the hospital between clinical presentation, followed by scrofuloderma, tuber- 1975 and 1995. culids, tuberculosis verrucosa cutis and tuberculous RESULTS: A total of 0.1% of dermatology patients had gumma. Some patients presented more than one clinical cutaneous tuberculosis. Lupus vulgaris was the com- form of the disease. Classification of cutaneous tuber- monest form, seen in 154 (55%) of these patients, fol- culosis needs to be modified to include smear-positive lowed by scrofuloderma in 75 (26.8%), tuberculosis ver- and smear-negative scrofuloderma apart from the inclu- rucosa cutis in 17 (6%), tuberculous gumma(s) in 15 sion of disseminated disease. The presence of regional (5.4%) and tuberculids in 19 (6.8%). No correlation lymphadenopathy serves as a clinical indicator of dis- was found between Mantoux reactivity and the extent of seminated disease.
    [Show full text]
  • A Rare Case of Tuberculosis Cutis Colliquative
    Jemds.com Case Report A Rare Case of Tuberculosis Cutis Colliquative 1 2 3 4 5 Shravya Rimmalapudi , Amruta D. Morey , Bhushan Madke , Adarsh Lata Singh , Sugat Jawade 1, 2, 3, 4, 5 Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India. INTRODUCTION Tuberculosis is one of the oldest documented diseases known to mankind and has Corresponding Author: evolved along with humans for several million years. It is still a major burden globally Dr. Bhushan Madke, despite the advancement in control measures and reduction in new cases1 Professor and Head, Tuberculosis is a chronic granulomatous infectious disease. It is caused by Department of Dermatology, Venereology & Leprosy, Mycobacterium tuberculosis, an acid-fast bacillus with inhalation of airborne droplets Jawaharlal Nehru Medical College, 2,3 being the route of spread. The organs most commonly affected include lungs, Datta Meghe Institute of Medical intestines, lymph nodes, skin, meninges, liver, oral cavity, kidneys and bones.1 About Sciences, Wardha, Maharashtra, India. 1.5 % of tuberculous manifestations are cutaneous and accounts for 0.1 – 0.9 % of E-mail: [email protected] total dermatological out patients in India.2 Scrofuloderma is a type of cutaneous tuberculosis (TB) which is a rare presentation in dermatological setting and is DOI: 10.14260/jemds/2021/67 difficult to diagnose. It was earlier known as tuberculosis cutis colliquative develops as an extension of infection into the skin from an underlying focus, usually the lymph How to Cite This Article: Rimmalapudi S, Morey AD, Madke B, et al. A nodes and sometimes bone.
    [Show full text]
  • A Cross Study of Cutaneous Tuberculosis: a Still Relevant Disease in Morocco (A Study of 146 Cases)
    ISSN: 2639-4553 Madridge Journal of Case Reports and Studies Research Article Open Access A Cross study of Cutaneous Tuberculosis: A still relevant Disease in Morocco (A Study of 146 Cases) Safae Zinoune, Hannane Baybay, Ibtissam Louizi Assenhaji, Mohammed Chaouche, Zakia Douhi, Sara Elloudi, and Fatima-Zahra Mernissi Department of Dermatology, University Hospital Hassan II, Fez, Morocco Article Info Abstract *Corresponding author: Background: Burden of tuberculosis still persists in Morocco despite major advances in Safae Zinoune its treatment strategies. Cutaneous tuberculosis (CTB) is rare, and underdiagnosed, due Doctor Department of Dermatology to its clinical and histopathological polymorphism. The purpose of this multi-center Hassan II University Hospital retrospective study is to describe the epidemiological, clinical, histopathological and Fès, Morocco evolutionary aspects of CTB in Fez (Morocco). E-mail: [email protected] Methods: We conducted a cross-sectional descriptive multicenter study from May 2006 Received: March 12, 2019 to May 2016. The study was performed in the department of dermatology at the Accepted: March 18, 2019 University Hospital Hassan II and at diagnosis centers of tuberculosis and respiratory Published: March 22, 2019 diseases of Fez (Morocco). The patients with CTB confirmed by histological and/or biological examination were included in the study. Citation: Zinoune S, Baybay H, Assenhaji LI, et al. A Cross study of Cutaneous Tuberculosis: Results: 146 cases of CTB were identified. Men accounted for 39.8% of the cases (58 A still relevant Disease in Morocco (A Study of 146 Cases). Madridge J Case Rep Stud. 2019; patients) and women 60.2% (88 cases), sex-ratio was 0.65 (M/W).
    [Show full text]
  • Coexistence of Tuberculous Gumma with Tuberculosis Verrucous Cutis (TBVC) in an Immunocompetent Female
    Our Dermatology Online Case Report CCoexistenceoexistence ooff ttuberculousuberculous ggummaumma wwithith ttuberculosisuberculosis vverrucouserrucous ccutisutis ((TBVC)TBVC) iinn aann iimmunocompetentmmunocompetent ffemaleemale Nishant Agarwala, Madhuchhanda Mohapatra, Trashita Hassanandani, Maitreyee Panda Department of Dermatology Venerology and Leprology, IMS and SUM Hospital, Bhubaneswar, Odisha, India Corresponding author: Dr. Trashita Hassanandani, E-mail: [email protected] ABSTRACT Tuberculous gummas and tuberculosis verrucosa cutis (TBVC) generally manifest in two extreme poles across the cell mediated immunity spectrum of cutaneous tuberculosis. The present case report refers to a 43 year old female with subcutaneous soft to firm non-tender, minimally fluctuant nodules & abscesses over digits of B/L hands and few well defined verrucous plaques over lateral aspects of bilateral soles. Ziehl-Neelsen stain did not demonstrate any acid fast bacilli. On histopathologic examination it was diagnosed as Tuberculous gumma with Tuberculosis Verrucosa cutis as per clinical diagnosis and its coexistence in a single individual is unique. The patient was treated with anti tubercular drugs (ATD) & responded well. Key words: Cutaneous tuberculosis; Tuberculous gumma; Tuberculosis verrucous cutis (TBVC); Immunocompetent INTRODUCTION the skin of previously infected patients having intact immunity. It manifests as a large verrucous Cutaneous tuberculosis constituting a small plaque with finger like projections at the margins. fraction about 1.5%
    [Show full text]
  • National Consensus
    National Consensus HIDRADENITIS SUPPURATIVA Published by the Sociedad Argentina de Dermatología [Argentine Society of Dermatology] – Year 1- No. 1 – November 2019 Location of editing: Ciudad Autónoma de Buenos Aires, Argentina 2019 Treatment Guideline ICD 10: L73.2 ICD 11: ED92.0 Synonym: acne inversa Autoinflammatory Disease and Hidradenitis Suppurativa Work Group of the Argentine Society of Dermatology DIRECTOR: Dr. Alberto Lavieri* AUTHORS: Dr. Mario Bittar Dr. Paula Bourren Dr. Jimena Estrada Dr. Sebastián Fagre Dr. Ramón Fernández Bussy (Jr) Dr. Claudio Greco Dr. Alberto Lavieri Dr. Virginia López Gamboa Dr. Mónica Maiolino Dr. Mariano Marini Dr. Mariana Papa Dr. Mario Pelizzari Dr. Ariel Sehtman Dr. María Florencia Vera Morandini Dr. Sabina Zimman* * Director and authors are members of the Autoinflammatory Disease and Hidradenitis Suppurativa Work Group of the Argentine Society of Dermatology A1 Table of Contents 1. Introduction ...................................................................................................................... 1 2. Premises ............................................................................................................................ 2 3. Background on hidradenitis suppurativa ............................................................................ 2 3.a. Definitions .................................................................................................................... 2 3.b. Epidemiology ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,.
    [Show full text]
  • Musculoskeletal Tuberculosis Presenting As Isolated Tuberculous Gumma in an Immunocompetent Patient
    Archive of SID MUSCULOSKELETAL IMAGING Iran J Radiol. 2018 April; 15(2):e59213. doi: 10.5812/iranjradiol.59213. Published online 2018 February 24. Case Report Musculoskeletal Tuberculosis Presenting as Isolated Tuberculous Gumma in an Immunocompetent Patient Taehoon Ahn,1 Seon-Kwan Juhng,1,* Guy Mok Lee,1 and Heon Soo Kim2 1Department of Radiology, Wonkwang University Hospital, Iksan, Republic of Korea 2Department of Pathology, Wonkwang University Hospital, Iksan, Republic of Korea *Corresponding author: Seon-Kwan Juhng, Department of Radiology, Wonkwang University Hospital, 895 Muwang-ro, Iksan, Korea. Tel: +82-638591920, Fax: +82-638594749, E-mail: [email protected] Received 2017 July 31; Accepted 2018 January 02. Abstract A 57-year-old woman with no significant past medical history and normal immunity presented with a slowly growing mass on her finger. MR imaging showed a low signal intensity soft tissue mass on both T1- and T2- weighted images with peripheral contrast enhancement. The mass was diagnosed as chronic granulomatous inflammation with caseous necrosis histopathologically and also Mycobacterium tuberculosis by a polymerase chain reaction about the tissue specimen. Authors thought that it was tuberculous gumma presented in an immunocompetent patient. This paper reports a rare case of tuberculous gumma with radiologic findings in an immunocompetent patient. Keywords: Tuberculous Gumma, Immunocompetency, MRI, Soft Tissue Mass 1. Introduction over the past 2 years; the patient also did not complain of any pain due to the mass or its surrounding area. Physi- Tuberculous gumma, also known as a metastatic tu- cal examination revealed a 3 × 3 cm swollen mass with- berculous abscess, is often secondary tuberculosis in im- out any abnormal findings such as erythema, ulcer, and munosuppressed patients, with diseases such as acquired discharge on the overlying skin at the ventral surface of immunodeficiency syndrome (AIDS), miliary tuberculosis her left third finger (Figure 1).
    [Show full text]
  • Cutaneous Tuberculosis in HIV Infected Patient Sept 2015; Published Date: 15 Sept 2015
    ISSN 2380-5536 SciForschenOpen HUB for Scientific Research Journal of HIV and AIDS Case Report Volume: 1.2 Open Access Received date: 24 May 2015; Accepted date: 8 Cutaneous Tuberculosis in HIV Infected Patient Sept 2015; Published date: 15 Sept 2015. Benabdellah A1*, Bachir N2, Belharane A2, Benabadji A2, Benchouk S2, Bensaha Z2, Brahimi Citation: Benabdellah A, Bachir N, Belharane A, 2 2 2 2 2 3 H , Lakhdori F , Mahamdaoui F , Taleb-Bendiab R , Touati SN , and Labdouni MH Benabadji A, Benchouk S, et al. (2015) Cutaneous 1University of Oran, Ahmed Benbella, Algeria Tuberculosis in HIV Infected Patient. J HIV AIDS 2CHU TLEMCEN, University of Oran, Algeria 1(2): http://dx.doi.org/10.16966/2380-5536.108 3CHU ORAN, University of Oran, Algeria Copyright: © 2015 Benabdellah A, et al. This is *Corresponding author: Benabdellah Anwar, HIV laboratory research, University of Oran, BP an open-access article distributed under the terms 1524 ELM Naouer 31000 Oran, Algeria, Tel: +213 (0) 41 58 19 47 /+213 (0) 41 58 19 41; of the Creative Commons Attribution License, E-mail: [email protected] which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract The presence of cutaneous miliary tuberculosis in the AIDS era emphasized the importance of having a high index of suspicion for this condition in HIV-positive patients with skin lesions and advanced immunodeficiency. We report a 38 year-old male patient, diagnosed with HIV infection that developed disseminated tuberculosis in chest, abdomen and skin. While pulmonary symptoms improved under antituberculous drugs, skin lesion showed positive cultures for 6 months.
    [Show full text]
  • 86A1bedb377096cf412d7e5f593
    Contents Gray..................................................................................... Section: Introduction and Diagnosis 1 Introduction to Skin Biology ̈ 1 2 Dermatologic Diagnosis ̈ 16 3 Other Diagnostic Methods ̈ 39 .....................................................................................Blue Section: Dermatologic Diseases 4 Viral Diseases ̈ 53 5 Bacterial Diseases ̈ 73 6 Fungal Diseases ̈ 106 7 Other Infectious Diseases ̈ 122 8 Sexually Transmitted Diseases ̈ 134 9 HIV Infection and AIDS ̈ 155 10 Allergic Diseases ̈ 166 11 Drug Reactions ̈ 179 12 Dermatitis ̈ 190 13 Collagen–Vascular Disorders ̈ 203 14 Autoimmune Bullous Diseases ̈ 229 15 Purpura and Vasculitis ̈ 245 16 Papulosquamous Disorders ̈ 262 17 Granulomatous and Necrobiotic Disorders ̈ 290 18 Dermatoses Caused by Physical and Chemical Agents ̈ 295 19 Metabolic Diseases ̈ 310 20 Pruritus and Prurigo ̈ 328 21 Genodermatoses ̈ 332 22 Disorders of Pigmentation ̈ 371 23 Melanocytic Tumors ̈ 384 24 Cysts and Epidermal Tumors ̈ 407 25 Adnexal Tumors ̈ 424 26 Soft Tissue Tumors ̈ 438 27 Other Cutaneous Tumors ̈ 465 28 Cutaneous Lymphomas and Leukemia ̈ 471 29 Paraneoplastic Disorders ̈ 485 30 Diseases of the Lips and Oral Mucosa ̈ 489 31 Diseases of the Hairs and Scalp ̈ 495 32 Diseases of the Nails ̈ 518 33 Disorders of Sweat Glands ̈ 528 34 Diseases of Sebaceous Glands ̈ 530 35 Diseases of Subcutaneous Fat ̈ 538 36 Anogenital Diseases ̈ 543 37 Phlebology ̈ 552 38 Occupational Dermatoses ̈ 565 39 Skin Diseases in Different Age Groups ̈ 569 40 Psychodermatology
    [Show full text]
  • Tuberculous Gummas with Sporotrichoid Pattern in a 57-Year-Old Female: a Case Report and Review of the Literature
    International Journal of Mycobacteriology 3 (2014) 66– 70 Available at www.sciencedirect.com ScienceDirect journal homepage: www.elsevier.com/locate/IJMYCO Review Tuberculous gummas with sporotrichoid pattern in a 57-year-old female: A case report and review of the literature I. Hadj a,*, M. Meziane a, O. Mikou a, K. Inani a, T. Harmouch b, F.Z. Mernissi c,a a Department of Dermatology, CHU Hassan II, Fe`s, Morocco b Laboratory of Pathology, CHU Hassan II, Fe`s, Morocco c CHU Hassan II, Fe`s, Morocco ARTICLE INFO ABSTRACT Article history: Sporotrichoid tuberculosis is a rare form of cutaneous tuberculosis; it primarily affects chil- Received 18 September 2013 dren after a post-traumatic inoculation. The diagnosis is often difficult and based on a set Received in revised form of arguments; it should be considered in any sporotrichoid lesion, especially in tuberculosis 22 October 2013 endemic countries. The following describes a new case of Mycobacterium tuberculosis skin Accepted 22 October 2013 infection with an unusual sporotrichoid clinical appearance in a healthy woman, empha- Available online 20 November 2013 sizing the diagnostic difficulties with a review of literature. Ó 2013 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights Keywords: reserved. Cutaneous tuberculosis Sporotrichoid pattern Gummas Contents Introduction . ................................................................................ 66 Case report . ................................................................................ 68
    [Show full text]
  • Military Dermatology, Index
    Index INDEX A Alkalis and acids and irritant contact dermatitis, 132 Abdomen Allen, Alfred M., 5, 112, 396, 425 and contact dermatitis, 136 Allergic contact dermatitis, 113-131 Achiya, Michihiko, 70, 71 and cashew, 118-119 Acids and clothing, 129-130 See Alkalis and acids and fragrances, 131 Acquired immunodeficiency syndrome (AIDS) and ginkgo, 119-120 and atypical mycobacterial infections, 404, 417 and Gluta, 120 and cryptococcosis, 481 and India marking nut tree, 117 and genital herpes infection, 531 and Japanese lacquer tree, 117-118 and leprosy, 352 and mango, 118 and molluscum contagiosum, 580-581 and metals, 125-128 and secondary syphilis, 503 and miscellaneous sensitizers, 131 and tuberculosis, 376, 377, 379 and plants, 113-114 See also Immunocompromised patients geographical distribution, 120-123 Acrocyanosis, 33 and poison ivy and poison oak, 114-117 clinical manifestations, 33 and poison sumac, 117 etiology, 33 and preservatives, 130-131 treatment, 33 and rubber compounds, 129 Acrodermatitis chronica atrophicans, 311 and shoes, 128-129 Actinomycosis, 483-485 and sunscreens, 125 Africa and topical drugs, 123-125 and dracunculiasis, 279 See also Atopic dermatitis; Contact dermatitis; Irritant and filariasis, 274 contact dermatitis and histoplasmosis, 457 Almeida, Louis, 323 and loiasis, 276 Altman, J., 562 and lymphogranuloma venereum, 522 Amebiasis, 268-269 and mycetoma, 476 clinical manifestations, 269-269 and onchocerciasis, 277, 278 diagnosis, 269 and schistosomiasis, 281 treatment, 269 and streptocerciasis, 279 Amenhotep
    [Show full text]
  • Accepted Paper
    Title: A rare case of scrofuloderma along with lupus vulgaris Authors: Chiara Sabbadini1, Julia Oberschmied1 , Martina Tauber2 , Carla Nobile1 Affiliations: 1 Department of Dermatology, Venereology and Allergology, Hospital Brunico, Brunico, Italy 2 Department of Pathology, Central Hospital Bolzano, Bolzano, Italy Corresponding Author: Hospital Brunico, Via Ospedale 11, 39031 Brunico, Italy, Tel.: +39 0474581230, Email: [email protected] Keywords: cutaneous tuberculosis, scrofuloderma, lupus vulgaris paper Chiara Sabbadini, Corresponding Author Julia Oberschmied, co-Author Martina Tauber, co-Author Carla Nobile, co-Author Potential conflicts of interest: The authors declare no conflicts of interests. Accepted This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the final one. Please cite this article as doi: 10.4081/dr.2021.8993 Abstract: Cutaneous forms of tuberculosis (TB) are rare, comprising about 1-1.5% of all cases, and show a wide range of clinical manifestations. Here we present a case of a patient with left cervical ulcerated lymphadenopathy associated with a violaceous plaque in the area of the manubrium of sternum. We performed a biopsy of the plaque for histopathology, a polymerase chain reaction (PCR) to test for mycobacteria and a smear of the ulcerated lymph node. Histopathology results showed a dermal infiltrate consisting of epithelioid granulomas without necrosis, PCR was negative and the culture was positive for M. tuberculosis. We made the diagnosis of scrofuloderma associated with lupus vulgaris. The patient was treated with an anti-tuberculous therapy with clinical regression of the lesions.
    [Show full text]
  • Original Article Cutaneous Manifestations of Extra Pulmonary
    Original Article Cutaneous Manifestations of Extra pulmonary Tuberculosis Ahmad S1, Ahmed N2, Singha JL3, Mamun MAA4, Hassan ASMFU5, Aziz NMSB6, Alam SI7 Conflict of Interest: None Abstract: Received: 12-08-2018 Background: Ulcers and surgical wounds not healing well and expectedly are common problems Accepted: 06-11-2018 www.banglajol.info/index.php/JSSMC among patients in countries like us. Ulcers may develop spontaneously or following a penetrating injury. wounds not healing well are common among poor, lower middle class and middle class people. Postsurgical non-healing wound or chronic discharging sinuses at the scar site are also common in that class of people. Suspecting malignancy or tuberculosis in these types of wounds we have sent wedge or excision biopsy for these ulcers in about 500 cases and found tuberculosis in 65 cases. In rest of the cases histopathology reports found as non- specific ulcers, Malignant melanoma, squamous or basal cell carcinoma, Verruca vulgaris. Objectives: To find out the relationship of tuberculosis with chronic or nonhealing ulcers. Methods: This is a prospective observational study conducted for patients coming to our chambers, OPD of a district general hospital and Shaheed Suhrawardy Medical College Hospital, Dhaka from July 2012 to June 2018. Results: Mean age of the study subjects were 28±2. Among the study subjects nonspecific ulcer or sinus tracts were found in 418 (83.6%), tuberculosis in 65 (13%), Malignant melanoma 7 (1.4%), Verruca vulgaris 5(1%), squamous cell carcinoma 3(0.6), basal cell carcinoma 2 (0.4%). Biopsy done only for very suspicious ulcers or wounds. Key Words: Cutaneous Conclusion: With this very small sample size it is difficult to conclude regarding incidence of manifestation, Extrapulmonary cutaneous involvement of extra pulmonary tuberculosis , but every clinician should think of it in case involvement, Tuberculosis.
    [Show full text]